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J Am Geriatr Soc. 2013 Oct;61(10):1651-60. doi: 10.1111/jgs.12451.

Practice-based learning can improve osteoporosis care.

Author information

1
Hess Consulting, St-Nicolas, Québec, Canada.

Abstract

OBJECTIVES:

To examine physician engagement in practice-based learning using a self-evaluation module to assess and improve their care of individuals with or at risk of osteoporosis.

DESIGN:

Retrospective cohort study.

SETTING:

Internal medicine and subspecialty clinics.

PARTICIPANTS:

Eight hundred fifty U.S. physicians with time-limited certification in general internal medicine or a subspecialty.

MEASUREMENTS:

Performance rates on 23 process measures and seven practice system domain scores were obtained from the American Board of Internal Medicine (ABIM) Osteoporosis Practice Improvement Module (PIM), an Internet-based self-assessment module that physicians use to improve performance on one targeted measure. Physicians remeasured performance on their targeted measures by conducting another medical chart review.

RESULTS:

Variability in performance on measures was found, with observed differences between general internists, geriatricians, and rheumatologists. Some practice system elements were modestly associated with measure performance; the largest association was between providing patient-centered self-care support and documentation of calcium intake and vitamin D estimation and counseling (correlation coefficients from 0.20 to 0.28, Ps < .002). For all practice types, the most commonly selected measure targeted for improvement was documentation of vitamin D level (38% of physicians). On average, physicians reported significant and large increases in performance on measures targeted for improvement.

CONCLUSION:

Gaps exist in the quality of osteoporosis care, and physicians can apply practice-based learning using the ABIM PIM to take action to improve the quality of care.

KEYWORDS:

osteoporosis; practice-based learning and improvement; quality improvement; quality measurement; systems-based practice

PMID:
24117284
DOI:
10.1111/jgs.12451
[Indexed for MEDLINE]
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